China and India made Pharmaceuticals ... ?

[LoneRanger]

Back in 2012 I went on generic Lexapro, or escitalopram. Low dose, 10mg. tapered off in 2014. CVS charged about $20 to fill 30 at that time.

Recently and reluctantly, went back on escitalopram, same low dose 10mg. Gave me constant headache, the background type that isn't severe it just is there and lingers all the time, a discomfort type not a resounding raging type. I had to taper off. Headaches went away.

This time around CVS was charging only $7 to fill 30. I did some open source research and found lots of complaints about headaches and escitalopram made in either China or India and that CVS and Walgreen's had both begun selling from those sources. Apparently the headache side effect is something related to purity of the fillers/buffers that the escitalopram is blended with. I also noticed that the tablets several yrs ago were smaller, about half the size as the ones CVS was dispensing this time around but both the same mg. That would seem to fit with the info about use of fillers or buffers since the same 10mg is now being dispensed in a tablet about twice the physical size.

I'm wondering if there is a way to ensure you get a med made in North America... US, Canada, or Mexico?

 

[Kamele0N]

Originally Posted By: LoneRanger

I'm wondering if there is a way to ensure you get a med made in North America... US, Canada, or Mexico?


Yes...every batch has its LOT number...and that tells you about its origin...

Compare LOT numbers (previous supplier VS what you have now)

 

[LoneRanger]

The tablets have no lettering or coding or anything on them. White round tablet scored down the middle so it can be broken in half easier, that's it.

 

[Kamele0N]

Hmmm could it be that US of A has different traceability system from EU...but I doubt somehow...

Browse trough FDA agency...
https://www.accessdata.fda.gov/scripts/cder/ndc/

LOT on EU made aspirine

 

[pandus13]

Originally Posted By: LoneRanger
The tablets have no lettering or coding or anything on them. White round tablet scored down the middle so it can be broken in half easier, that's it.

I think he is referring to the lettering on the package/bottle...

 

[Zee09]

And they told me here all pharma's are the same because we have the FDA
Of course that is hogwash. when we started sourcing our meds and supplements from anywhere that
would make them for pennies on the $$$ the side effects started showing up.

After the nonsense on here I spent several hundred $$$ looking to find out why the same meds I always took turned on me.
When the results came back I had my answers. All meds were as pure as the water in Love Canal.

 

[goodtimes]

Talk to your doctor. I get migraines, what you describe sounds like low level migraine headache. You can try non generic and compare.

 

[rshaw125]

A lot of generics are made overseas. Cheaper. Why not buy from Canada??/

 

[mclasser]

I take Singular for asthma-related allergies and never had an issue with name brand stuff. Once it went generic, my insurance company forced me to get the overseas-made pills and I began getting side effects I never had before. Go figure.

 

[LoneRanger]

Originally Posted By: goodtimes
Talk to your doctor. I get migraines, what you describe sounds like low level migraine headache. You can try non generic and compare.


It had to have been from starting on the generic since within a week of weaning off, it went away. I have a regularly scheduled appt in August at which time I will discuss. I know they can write it as "dispense only as written" for brand name, but I'm not sure the bargain basement prescription plan on my employee health insurance will allow that. I think they make all employees get generics only, might be on your own dime if you want brand name. Will have to look into it.

The big give away that there's a lot of fillers being used is the tablet is double the physical size as the ones from five years ago, but still the same 10mg content of active escitalopram.

*Think* I read where the FDA requires that if a foreign drug maker is going to export to the USA then they have to submit to FDA inspections of their site(s). But apparently the FDA is short on ability to cover the many new foreign located drug manufacturing facilities because they just don't have enough inspectors overseas to do the job. And in a few cases the foreign sites have been somewhat obstructive to FDA inspectors upon the site visit.

 

[loneryder]

I spent over 35 yrs in the pharma business. I would never use anything made in China. There is no control or oversight. A few yrs ago the drugs from India were ok because they had US standards but I don't know about today. The FDA hardly inspects US plants and we have learned recently how efficient our Govt. is. Also generics can be up to 20% off the stated label with regards to strength. If you Dr. Rx's say 100mg of something, you could only be getting 80+%. People who are on a drug for a long time then are switched to generics will notice. If you are on thyroid and use a generic, you will never get regulated. It's the Wild West out there people.
But there's not much we can do about generics due to the insurance.

 

[rshaw125]

Boycott the US medical cartel and buy from Canada. One site I have used tells you where the drug is manufactured.

 

[Johnny2Bad]

There are almost constant cases of India Pharma manufacturers selling pharmaceuticals that have reduced or even no active ingredients; if they are being prosecuted in India you can be sure the problem isn't rare.

Now, India makes massive amounts of drugs; there are reliable suppliers but an ordinary consumer doesn't have the information necessary to vet suppliers.

I would not trust China-sourced drugs not manufactured in a plant that has western Pharmaceutical corporation oversight. Counterfeiting from China is so widespread on so many products ... Autometer is plagued by them, for example, and counterfeit electronic components ... we're talking capacitors and simple transistors here, selling for as little as 10c or even less a copy, and the counterfeiters are making money at that price. Imagine the profits that could be made from a simple pill press, which are inexpensive enough that anyone here on the forum could buy one. The only expense increase comes from how many thousands of pills per hour you want to make.

Canada has some of the best generic drug manufacturers in the world, I don't know the exact source of every drug, obviously, but I do see domestic manufactured Patent and Patent-expired drugs plus I've bought drugs from the Pharmacy labeled "Made in USA for export only to Canada".

UK has extensive domestic pharma manufacturing as well as Germany, which has had a leading chemical / pharma industry for more than 100 years. Many current US-based pharma corporations originated in Germany (eg: Searle, now part of Phizer. G.D. Searle was a German immigrant whose own ancestors had drug companies in Germany. Notable Patents include the first Oral Contraceptives, Nutrasweet, Metamucil, Dramamine, Ambien, etc). I know members of the Searle family as they were clients of my employer.

Although obviously there is incentive to import drugs from Canada for US residents, manufacturers naturally make drugs in quantities relative to domestic demand, and any blip in that demand caused by exports can cause shortages in Canada, so it's discouraged and pharmacies that cater to that trade will have regulatory issues, sooner or later. I don't think it's a sustainable option.

There is a top level domain in Canada .pharmacy (and has vetted providers in most countries, so USA as well) that is regulated and insures bona-fide products for online transactions with doctor's prescription. You can't fill a prescription not issued by a licensed-in-Canada doctor except on emergency situations (will require the US licensed doctor to correspond with a Canadian licensed one).

My Thyroid meds are generics manufactured in Canada, and my issue is regulated just fine, thanks.

 

[nthach]

Originally Posted By: Johnny2Bad

Canada has some of the best generic drug manufacturers in the world, I don't know the exact source of every drug, obviously, but I do see domestic manufactured drugs plus I've bought drugs from the Pharmacy labeled "Made in USA for export only to Canada".

UK has extensive domestic pharma manufacturing as well as Germany, which has had a leading chemical / pharma industry for more than 100 years. Many current US-based pharma corporations originated in Germany (eg: Searle, now part of Phizer).


I know Kaiser Permanente, a major HMO in California(and a big buyer of drugs besides Express Scripts/CVS-Aetna/Walgreens Boots Alliance) and a few other states where Kaiser Industries had a presence during WWII does source a few things from Apotex. Generic Flonase for many distributors is made by Apotex, and their stuff is a chemical for chemical copy of the real thing made by Glaxo and both are made in Canada.

The drug companies are now holding "captive" generics divisions - Novartis rehashed the Sandoz name for their generics arm and Sanofi Aventis brought back the Winthrop name to sell that was their brand names when they become off-patent. The Indian companies enter partnerships with the majors to sell authorized generics - a tat for tat copy of the original.

With Amazon entering the pharmacy arena and the insurance companies getting into tighter relationships with drugstore/pharmacy chains(like the CVS and Aetna merger) there's gonna be more price pressure and maybe mergers or partnerships with retailers(like the Target-CVS partnership). Sure, Wal-Mart made ripples with cheap generics for $5/30-day supply but Wally-World doesn't have the disruption power of Amazon nor the relationships with pharmacy benefit management companies like Express Scripts or HMOS/PPOs.

 

[PandaBear]

The counterfeit drug problem in China is usually on their domestic market. Small pharmacies buy from distributors that may swap out name brand for generic with fake packaging. The international name brands' own made in China drugs seems good so far (Tylenol for example). So far I have good luck with CVS generic in Target, but I know they are of lower quality (i.e. their recent change in fluoride + multivitamin droplets for kids have sodium benzoate in it. I do not like these kind of stuff added to the drug, made in China or not.

Walgreen used to be the last good place that still carry the better stuff but it seems like they are forced to lower quality to compete as well now. Gresham's law.

 

[Johnny2Bad]

Originally Posted By: nthach

{snip}
Generic Flonase for many distributors is made by Apotex, and their stuff is a chemical for chemical copy of the real thing made by Glaxo and both are made in Canada.


Yes, I've used Patent Flonaise (from prescription, and now available over-the-counter) and my last purchase was a generic (Food / Pharmacy national retailer house brand) that seems to work just fine, price was about 20% cheaper OTC.

120 dose Glaxo is about $C 25 [$US 19.50], generic $C 20 [$US 15.60] (street prices; I've seen it higher at some pharmacies). As it's now OTC my drug plan no longer covers the Patent version (most OTC are, eg ASA 81, but this seems to be a cost-cutting new exception with my plan) so price becomes a factor.

EDIT: Just checked the bottle, manufactured in Toronto by Apotex. For some reason I though I had bought it at Safeway Pharmacy but the brand is Equate which is Wall-Mart

 

[LoneRanger]

Originally Posted By: rshaw125
Boycott the US medical cartel and buy from Canada. One site I have used tells you where the drug is manufactured.


Can you PM me that website?

 

[Nick R]

Originally Posted By: loneryder
I spent over 35 yrs in the pharma business. I would never use anything made in China. There is no control or oversight. A few yrs ago the drugs from India were ok because they had US standards but I don't know about today. The FDA hardly inspects US plants and we have learned recently how efficient our Govt. is. Also generics can be up to 20% off the stated label with regards to strength. If you Dr. Rx's say 100mg of something, you could only be getting 80+%. People who are on a drug for a long time then are switched to generics will notice. If you are on thyroid and use a generic, you will never get regulated. It's the Wild West out there people.
But there's not much we can do about generics due to the insurance.



"The FDA hardly inspects US plants"

To be honest, I find it hard to believe you spent over 35 years in the pharma business. I've worked in pharma for the last few years and I can tell you unequivocally that is FALSE. We are subject to minimum 2 FDA GMP inspections every year, and they are extremely thorough when investigating cGMP/GXP compliance- they are here for a full week every time.

 

[LoneRanger]

Originally Posted By: Nick R


To be honest, I find it hard to believe you spent over 35 years in the pharma business. I've worked in pharma for the last few years and I can tell you unequivocally that is FALSE. We are subject to minimum 2 FDA GMP inspections every year, and they are extremely thorough when investigating cGMP/GXP compliance- they are here for a full week every time.


Yeah but is FDA able to devote the same level of detail to a myriad of drug factories in India and China? Nope.

 

[Leo99]

Originally Posted By: LoneRanger
Originally Posted By: Nick R


To be honest, I find it hard to believe you spent over 35 years in the pharma business. I've worked in pharma for the last few years and I can tell you unequivocally that is FALSE. We are subject to minimum 2 FDA GMP inspections every year, and they are extremely thorough when investigating cGMP/GXP compliance- they are here for a full week every time.


Yeah but is FDA able to devote the same level of detail to a myriad of drug factories in India and China? Nope.



Each company selling drug in the USA is also responsible for quality of their product. I've been to Asia, Europe, and many states to inspect drug manufacturing facilities. A lot of raw materials and APIs used in drug products are sourced in Asia.

Generic companies have it a lot easier to get drug on the market. The innovator company needs to file a New Drug Application while generics file an Abbreviated New Drug Application where they are not performing any safety or efficacy studies. They only need to show bio-equivalence.

Generic drug applications are termed "abbreviated" because they are generally not required to include preclinical (animal) and clinical (human) data to establish safety and effectiveness. Instead, generic applicants must scientifically demonstrate that their product is performs in the same manner as the innovator drug. One way applicants demonstrate that a generic product performs in the same way as the innovator drug is to measure the time it takes the generic drug to reach the bloodstream in healthy volunteers.

I'm not aware of any antibiotics that aren't made in Asia (China or India).